UK gives £5.8 billion more to EU countries for medical costs than it gets back

Vote Leave can today reveal that the UK pays on average £723 million a year more to EU countries for the medical treatment of UK nationals than it receives back for treating EU nationals.

Under EU legislation, persons temporarily staying in and some permanent residents in another member state (such as a UK pensioner living in Spain) may be entitled to benefits in kind ‘which become necessary on medical grounds during their stay’. Member states are in theory required to reimburse medical costs incurred by their nationals overseas. Greater numbers of British holidaymakers visit the EU compared to EU citizens visiting the UK but this is balanced out by the fact there are 2.7 million EU citizens living in the UK, but just 1.1 million UK citizens living in the EU. The disparity in treatment costs shows that the UK is currently getting a bad deal and why the UK could secure friendly health co-operation with the EU after we Vote Leave.

The research shows that:

Since records began in 2007-2008, the UK has paid £6.18 billion to other EU member states for the treatment of British citizens in the EU, but was able to recoup just £405 million from other EU countries for the cost of treating EU citizens in the UK, a payment gap of £5.78 billion.
The UK’s payments to other EU countries for healthcare over the last eight years average £772 million per year (gross) and £723 million (net). The net figure is enough to more than double spending on the NHS Cancer Drugs Fund, to pay the salaries of an additional 2,638 GPs, to abolish dental fees and charges in England or abolish Prescription Charges.
Just in 2014-2015 alone, the UK paid £667.4 million to other EU countries for the treatment of British citizens in the EU, but was able to recoup just £49.3 million from the EU for the cost of treating EU citizens in the UK, a deficit of £618 million. That is enough to employ an additional 4,458 NHS hospital consultants or to abolish prescription fees and charges in England.

Commenting, Vote Leave Chair Gisela Stuart said:

‘The UK has been getting short changed by the EU for years. We hand over £350 million to Brussels every week but get less than half of that back - with strings attached.

‘On top of that, health tourism from the EU has cost us billions. This money could have been much better spent - it could have been invested to improve care for NHS patients.

‘If we Vote Leave we will be able to stop handing over so much money to the EU and we would be able to spend our money on priorities here in the UK like abolishing prescription charges and investing in the NHS.’

Notes to Editors

Under EU legislation, persons temporarily staying in another member state may be entitled to benefits in kind ‘which become necessary on medical grounds during their stay’. This also applies to those in receipt of a British state pension who have retired elsewhere in the EU (Regulation 2004/883/EC, ars. 19 & 27, link). Member states are in theory required to reimburse medical costs incurred by their nationals overseas in these circumstances (Decision No S1, 2010/C 106/08, link)

In 2014, there were 23.0 million visits by EU citizens to the UK and 43.8 million visits by British citizens to the EU (ONS, January 2016, link). This means there were 90.4% more visits by British citizens to the EU than there were visits by EU citizens to the UK. The scheme could, therefore, be expected to cost the UK more for temporary visits. Given that there are 2.7 million EU citizens in the UK, but just 1.1 million UK citizens in the EU, it might be thought that this scheme would not impose costs on the taxpayer and should actually result in a net income to the UK in respect of permanent residents (Oxford University Migration Observatory, May 2014,link). Permanent residents are also necessarily resident for longer periods of time, meaning they are liable to impose higher costs. It is hard to estimate in advance whether the UK should be paying more to the EU or vice versa.

Vote Leave requested data from the Department of Health under the Freedom of Information Act 2000. The information requested was:

‘(a) the amount paid by the UK to each EU member state for the cost of treating British citizens abroad and (b) the amount paid by each EU member state to the UK for the cost of treating EU citizens in the United Kingdom, for the financial year 2014-2015 and every previous year for which the Department has records.’

The Department of Health disclosed the data in full. A breakdown of the data by each EU member state is provided in the Annex. The table below shows the annual figures for the whole of the EU-27.

Annual claims
Year	EU-27 claims	UK claims	Net
2007-2008	£626.35 m	£45.88 m	(£580.47 m)
2008-2009	£705.19 m	£47.18 m	(£658.01 m)
2009-2010	£831.50 m	£57.17 m	(£774.33 m)
2010-2011	£919.24 m	£57.81 m	(£861.43 m)
2011-2012	£897.40 m	£48.45 m	(£848.95 m)
2012-2013	£791.10 m	£48.72 m	(£742.38 m)
2013-2014	£742.67 m	£50.18 m	(£692.49 m)
2014-2015	£667.42 m	£49.32 m	(£618.09 m)
Average	£772.61 m	£50.59 m	(£722.02 m)

In 2014-2015, EU member states claimed £667.4 million for the treatment of British citizens in the EU, whereas the UK was able to claim just £49.3 million, less than a thirteenth of money paid by the UK abroad. If the UK recouped what money in proportion to the number of visitors between the EU and the UK, it would obtain more than seven times what it actually does. The deficit in 2014-2015 amounted to a deficit of £618.1 million. This is enough:

To employ an additional 4,458 NHS hospital consultants (National Audit Office, February 2013, link).
To abolish prescription fees and charges in England (NHS England, July 2015, link).

Over the period 2007-2008 to 2014-2015 as a whole, EU member states claimed an average of £772.6 million for the treatment of British citizens in the EU, whereas the UK was able to claim just £50.6 million. This amounts to an average annual deficit of £722.0 million. This is enough:

To increase spending on the Cancer Drugs Fund by 112% (NHS England, January 2015, link).
To pay the salaries of an additional 2,638 GPs (Health and Social Care Information Centre, September 2015, link).
To abolish dental fees and charges in England (NHS England, July 2015, link).

The data also reveal the cumulative total claims made by and against the UK for medical costs, as the table below shows:

Cumulative claims
Year	EU claims	UK claims	Net
2007-2008	£626.35 m	£45.88 m	(£580.47 m)
2008-2009	£1,331.55 m	£93.06 m	(£1,238.48 m)
2009-2010	£2,163.05 m	£150.24 m	(£2,012.81 m)
2010-2011	£3,082.29 m	£208.05 m	(£2,874.24 m)
2011-2012	£3,979.69 m	£256.50 m	(£3,723.20 m)
2012-2013	£4,770.79 m	£305.21 m	(£4,465.58 m)
2013-2014	£5,513.46 m	£355.40 m	(£5,158.06 m)
2014-2015	£6,180.88 m	£404.72 m	(£5,776.16 m)

The graph shows that in the period 2007-2008 to 2014-2015, the UK has paid £6.18 billion to other EU member states for the treatment of British citizens in other EU countries, but was able to recoup just £405 million from other EU member states for the cost of treating EU citizens in the UK, a total payment gap of £5.78 billion. This is enough:

To have built new 17 new 1,159 bed hospitals (Derby Teaching Hospitals NHS Foundation Trust, 2016, link).
To have trained 71,480 NHS nurses, 14,982 GPs or 11,352 consultants (Personal Social Services Research Unit, 2015, link).
To have purchased and fitted out over 1,100 new GP surgeries (MedEconomics, July 2014, link).

Annex: EU Medical Costs Member State & UK Claims Resource Outturn Totals: 2007-08 to 2014-15

EU member state

2007-2008

2008-2009

2009-2010

2010-2011

2011-2012

2012-2013

2013-2014

2014-2015

EU claims

UK claims

EU claims

UK claims

EU claims

UK claims

EU claims

UK claims

EU claims

UK claims

EU claims

UK claims

EU claims

UK claims

EU claims

UK claims

Austria

£2.62 m

£0.71 m

£3.17 m

£0.60 m

£6.66 m

£0.71 m

£6.31 m

£0.49 m

£6.44 m

£0.25 m

£6.75 m

£0.24 m

£7.38 m

£0.34 m

£5.47 m

£0.37 m

Belgium

£4.19 m

£2.92 m

£5.65 m

£2.12 m

£5.94 m

£3.41 m

£5.55 m

£3.88 m

£5.82 m

£3.97 m

£5.84 m

£4.25 m

£8.28 m

£4.27 m

£5.82 m

£4.32 m

Bulgaria

£0.07 m

£0.00 m

£0.11 m

£0.00 m

£0.17 m

£0.00 m

£0.23 m

£0.03 m

£0.22 m

£0.15 m

£0.17 m

£0.32 m

£0.25 m

£0.35 m

£0.26 m

£0.36 m

Cyprus

£4.75 m

£0.00 m

£5.92 m

£0.01 m

£8.25 m

£0.00 m

£10.27 m

£0.08 m

£11.52 m

£0.15 m

£11.40 m

£0.14 m

£12.31 m

£0.44 m

£10.13 m

£0.35 m

Czech Republic

£0.23 m

£0.00 m

£0.33 m

£0.01 m

£0.46 m

£0.11 m

£0.54 m

£0.07 m

£0.83 m

£0.10 m

£0.80 m

£0.08 m

£0.68 m

£0.08 m

£0.62 m

£0.47 m

Denmark*

£0.00 m

N/A

Estonia*

£0.00 m

N/A

£0.10 m

N/A

£0.08 m

N/A

£0.15 m

Finland*

£0.02 m

£0.00 m

£0.03 m

£0.00 m

£0.01 m

£0.00 m

£0.01 m

£0.00 m

£0.01 m

£0.21 m

£0.02 m

£0.39 m

£0.01 m

£0.24 m

France

£136.11 m

£5.59 m

£154.54 m

£5.05 m

£209.61 m

£6.08 m

£213.73 m

£6.31 m

£196.69 m

£6.31 m

£183.64 m

£6.58 m

£151.87 m

£6.57 m

£147.69 m

£6.73 m

Germany

£12.80 m

£1.28 m

£15.20 m

£1.23 m

£18.99 m

£1.68 m

£19.41 m

£2.28 m

£21.53 m

£2.08 m

£22.06 m

£1.96 m

£25.23 m

£1.93 m

£25.87 m

£2.19 m

Greece

£3.57 m

£0.09 m

£5.07 m

£0.62 m

£5.32 m

£1.03 m

£6.73 m

£0.76 m

£7.85 m

£0.49 m

£8.36 m

£0.42 m

£8.86 m

£0.45 m

£2.68 m

£1.73 m

Hungary*

£0.00 m

£0.01 m

£0.00 m

£0.01 m

£0.00 m

£0.04 m

£0.00 m

£0.02 m

£0.00 m

£0.04 m

£0.00 m

£0.02 m

Ireland

£303.22 m

£21.62 m

£331.16 m

£24.49 m

£341.62 m

£28.99 m

£377.59 m

£32.19 m

£368.30 m

£23.09 m

£271.75 m

£21.95 m

£246.32 m

£22.38 m

£215.31 m

£19.21 m

Italy

£9.93 m

£5.29 m

£8.65 m

£6.28 m

£10.22 m

£6.17 m

£9.70 m

£0.67 m

£10.87 m

£0.85 m

£10.17 m

£1.03 m

£6.17 m

£1.05 m

£7.30 m

£1.51 m

Latvia

£0.03 m

£0.00 m

£0.02 m

£0.00 m

£0.02 m

£0.01 m

£0.03 m

£0.01 m

£0.04 m

£0.06 m

£0.03 m

£0.12 m

£0.02 m

£0.24 m

£0.01 m

£0.30 m

Lithuania

£0.02 m

£0.00 m

£0.02 m

£0.00 m

£0.02 m

£0.01 m

£0.02 m

£0.01 m

£0.04 m

£0.08 m

£0.07 m

£0.01 m

£0.10 m

£0.20 m

£0.28 m

£0.29 m

Luxembourg

£0.00 m

£0.24 m

£0.00 m

£0.41 m

£0.02 m

£0.53 m

£0.03 m

£0.61 m

£0.11 m

£0.62 m

£0.06 m

£1.21 m

£0.06 m

£0.68 m

£0.08 m

Malta*

£0.00 m

N/A

Netherlands

£6.68 m

£2.81 m

£7.95 m

£2.61 m

£5.58 m

£3.84 m

£4.96 m

£3.91 m

£8.10 m

£4.21 m

£8.48 m

£4.41 m

£9.90 m

£4.40 m

£8.66 m

£3.25 m

Poland

£0.75 m

£0.00 m

£1.05 m

£0.02 m

£1.47 m

£0.19 m

£3.56 m

£0.48 m

£1.61 m

£0.96 m

£5.67 m

£1.05 m

£6.10 m

£1.06 m

£4.34 m

£1.52 m

Portugal

£2.80 m

£0.05 m

£2.17 m

£0.18 m

£5.74 m

£0.56 m

£4.97 m

£0.70 m

£5.77 m

£0.64 m

£5.89 m

£0.78 m

£6.30 m

£0.69 m

£6.35 m

£0.70 m

Romania

£0.02 m

£0.00 m

£0.01 m

£0.00 m

£0.01 m

£0.00 m

£0.01 m

£0.23 m

£0.01 m

£0.28 m

£0.01 m

£0.27 m

£0.01 m

£0.27 m

£0.01 m

£0.50 m

Slovakia

£0.06 m

£0.00 m

£0.42 m

£0.00 m

£0.77 m

£0.00 m

£0.88 m

£0.04 m

£0.67 m

£0.04 m

£0.43 m

£0.06 m

£0.47 m

£0.07 m

£0.44 m

£0.12 m

Slovenia

£0.22 m

£0.24 m

£0.15 m

£0.06 m

£0.20 m

£0.18 m

£0.23 m

£0.06 m

£0.21 m

£0.11 m

£0.33 m

£0.13 m

£0.33 m

£0.25 m

£0.27 m

£0.11 m

Spain

£136.93 m

£4.12 m

£162.01 m

£2.83 m

£208.39 m

£2.85 m

£252.33 m

£4.17 m

£247.32 m

£3.24 m

£245.64 m

£3.20 m

£248.64 m

£3.22 m

£223.29 m

£3.41 m

Sweden

£1.36 m

£1.16 m

£1.36 m

£1.07 m

£1.61 m

£1.28 m

£1.66 m

£1.41 m

£2.95 m

£1.29 m

£2.98 m

£1.34 m

£2.22 m

£1.36 m

£1.92 m

£1.37 m

Total

£626.35 m

£45.88 m

£705.19 m

£47.18 m

£831.50 m

£57.17 m

£919.24 m

£57.81 m

£897.40 m

£48.45 m

£791.10 m

£48.72 m

£742.67 m

£50.18 m

£667.42 m

£49.32 m

Note: * indicates a waiver, which is an ‘agreed intentional relinquishment of healthcare costs between Member States’.

Prescriptions charges

Persons in England pay over £500 million per year in prescriptions charges.

NHS, 21 July 2015,link.